The Health Select Committee’s report into public health was welcomed by The Faculty of Public Health (FPH), who appreciates the report’s recommendations of addressing their main concerns on the impact of public health in terms of the Health and Social Care Bill. According to the FPH, the recommendations now have to be backed up by their proposed amendments to the bill and are being debated by the Lords. This will provide the UK with a robust public health system that is suited for emergency purposes but also in the long-term.

The Select Committee particularly recommends that it is crucial for the government to review its opposition to compulsory regulation of public health specialists. The FDH has submitted an amendment to that effect because the public should be able to trust those people who make life-or-death decisions about their health. Members of the FPH support this regulation so that all public health specialists can be held accountable.

The following are the FPH’s main areas of concern:

  • Lawful registration for all public health specialists to ensure adequate public protection
  • Entrenching health expertise in all commissioning, particularly in the NHS Commissioning Board
  • Ensuring that Directors of Public Health have the right seniority to maximize health gains for their local communities, and providing them with access to vital information and contacts, and
  • Clarity in terms of who is responsible for emergency and outbreaks management
  • Lawful registration for all public health specialists to ensure adequate public protection

The public is entitled to be able to trust those people who make life-or-death decisions about their health. This could entail deciding whether or not to immunize children, or how to manage disasters, such as flooding or a swine-flu outbreak. Thankfully, so far no public health specialist has seriously erred in his/her judgment, so that no unnecessary crisis has occurred, however, according to the FPH the public should not wait until such a crisis occurs before holding all specialists to account. As part of this regulation, the Health and Social Care Bill needs to define the role of a public health expert or consultant. This is effectively an extension of existing regulations for public health doctors and dentists.

The NHS Commissioning Board needs at least one member who is a public health specialist, to ensure the public’s health is protected

It is absolutely crucial that public health specialists, who have knowledge in terms of commissioning for entire populations, have an input in national decisions regarding NHS services because the NHS Commissioning Board will be nationally accountable for the outcomes achieved by the NHS. Otherwise, the risk remains that the health of entire communities will be put into jeopardy, in particular those people who are hard to reach.

Directors of public health need direct access to senior leaders

Under the Health and Social Care Bill, local authorities will employ Directors of Public Health (DPH). DPHs however require direct access to senior local leaders in order to drive through public health gains for their community. This is one of the reasons why the FPH believes that DPHs must be appointed as chief officers at a corporate or strategic director level, such as that of Director of Adult Social Services. The other reason being that DPHs also need to be able influence commissioning decisions made by GPs to ensure that local people receive the right services.

It needs to be clear that local authorities are responsible for public health outbreaks or emergencies

The Bill does not explicitly state that local authorities should be responsible for ensuring the proper management of outbreaks and emergencies. According to the FPH, Public Health England, the NHS and local authorities should have a duty to co-operate. Clarification is therefore needed to avoid putting the public at risk of serious harm.

Written by: Petra Rattue